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About this factsheet and who it is for
This factsheet aims to help anyone
reaching later life begin to think aboutwhat measures might be taken to anticipate or prevent problems in later life.
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Advice for older people
Living longer - remaining independent
April 2019
The artwork on the front of this factsheet was done by an older artist for EAC's over 60s Art Awards.
FACTSHEET 24
FirstStop Advice www.housingcare.org hoop.eac.org.uk
1
Contents
Section 1 Remaining independent Page 2
i) Preventing falls Page 2
ii) Knowing when to accept help Page 3
Section 2 Staying put or moving on? Page 4
Section 3 The main tasks that older people have difficulty with Page 4
i) Household tasks and gardening Page 5
ii) Getting out and about Page 6
iii) Shopping Page 7
iv) Managing bills and personal affairs Page 7
v) Keeping active Page 8
vi) Maintaining social networks Page 9
vii) Meal preparation Page 10
viii) Managing personal care Page 10
ix) Telecare Page 12
x) Carer responsibilities Page 13
Section 4 Conclusion Page 13
Section 5 About FirstStop Advice Page 14
FirstStop Advice www.housingcare.org hoop.eac.org.uk
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Remaining Independent
Independence may mean different things
to different people but most people
throughout their lives place a very high
value on the idea of independence. They
want to be able to make their own
decisions, to support themselves
financially, to take care of their own
physical and emotional needs. This is no
different in later life.
The aim of this leaflet is to help anyone
approaching advancing years to think
about what measures might be taken to
anticipate or prevent problems in later
life with the ultimate aim of enabling you
to remain in control of your life and stay
as independent as possible, for as long as
possible. Many of the suggestions here
are quite simple and require very small
changes but they are often things that we
tend to put off and sometimes leave until
it is too late.
The good news is that life expectancy in
the UK continues to rise. A man aged 65
years in 2014 can expect on average to
live for a further 18.4 years and a woman
another 20.9 years. (Source: Office for
National Statistics, February 2016)
Many people live full and active lives well
into old age and manage to remain
relatively independent requiring little
assistance with their needs. Others are
not so fortunate and because of frailty,
gradual physical or mental decline or a
sudden health crisis, they may find that
they are faced with the need to evaluate
how they will live in the future.
Where to Start?
Preventing falls
The number of falls experienced by older
people is very high. One third to one half
of people over 65 years fall each year;
furthermore over 400,000 older people in
England attend accident and emergency
departments following an accident and
up to 14,000 people die annually in the
UK as a result of a hip fracture. (Source:
National Service Framework for Older
People) Falling is a major cause of
disability and greatly affects health and
ability to manage daily life.
The statistics illustrate how important it is
to address and reduce the risk of falls in
your home and there are lots of simple
measures that you can take.
Here are some considerations:-
Do you have adequate lighting in your home?
Are there any obvious tripping hazards like loose mats or uneven floor coverings? Even if these have been in
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place for years without problems, now is the time to remove them.
Are you careful about not leaving tripping hazards on the floor or stairs?
Do you have your eyes checked regularly?
Do you take risks with step ladders or stand on chairs to reach windows, light bulbs or cupboards?
Are your shoes/slippers safe and comfortable?
If you have suffered unexplained falls or lack of balance, have you considered speaking to your GP? There may be a medical explanation; you could even be taking a medication that increases the risk of you falling.
Is walking or balance becoming more difficult or do you have difficulty getting out of bed or out of a chair? You could seek advice from your local Home Improvement Agency or ask for an Occupational Therapy assessment. Rails and aids are often provided free of charge or you can arrange to buy your own.
Regular exercise and optimising your fitness levels is another way of helping to reduce the risk of falls.
Taking measures to prevent falls is an
easy way of exercising your independence
and by preventing a fall you are likely to
remain independent for longer.
Knowing when to accept some help –
the key to enhancing independence
As we get older it is common for people
to find that some of the simple everyday
tasks take longer to do, or are more
difficult, or may no longer be safe for us
to do ourselves. There are fortunate
people who remain positive, healthy and
active throughout their life. They may
have the benefit of good health but if you
look closer you may find that there are
other clues to their apparent good
fortune. They may live in a property that
suits their needs well; they may have a
good network of friends who provide
support and help; they may have help
with the things that they find difficult or
the things they no longer enjoy doing; this
enables them to continue their interests
and hobbies and the things that they are
able to do for themselves.
Accepting that ageing is just another
stage in your life story, and one that
requires all the same problem solving
skills that you have employed throughout
your life, will help you to remain
empowered to make the right decisions
for you. It is never too early to think
about what problems could occur in the
future and start to think about and
research alternatives as to how you will
manage. It is much harder to make
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important decisions and feel in control of
the situation when a crisis occurs.
Staying put or moving on?
One of the hardest considerations may be
whether or not to downsize or possibly
move to a sheltered or retirement
development. There are lots of pros and
cons to think about and every person’s
situation is different.
FirstStop provides a variety of useful
factsheets on this subject with
explanations of the various types of
specialist housing for older people and
what services they may or may not offer.
Our HousingCare website has a full
directory of retirement housing options
throughout the country together with
contact details etc. All of the above
information is available at
www.housingcare.org.uk.
People who have lived in their home for
many years are often reluctant to move.
They feel attached to their house, garden
and surroundings. They may be
concerned to pass on their property to
their loved ones, they may be unable to
contemplate the upheaval of moving,
organising a move to a new property and
the disposal of possessions that have
accumulated over the years. This is
understandable and “staying put” may
well be right for many people. Even so,
our advice is to keep an open mind
because if your house, for whatever
reason, has become a burden to you, you
might discover that finding the right move
could greatly improve your quality of life.
FirstStop provides a very useful “Housing
Options Tool” to help you to look at all
the aspects of your current
accommodation and assess whether it
continues to serve your needs. There is
help and advice available to enable you to
“stay put” and there are services in some
areas to assist with the practicalities of
moving. Visit hoop.eac.org.uk for more
information.
The main tasks older people have difficulty with
Household tasks and gardening
Getting out and about
Shopping
Managing bills and personal affairs
Keeping active
Maintaining contact with friends, family and social networks
Meal preparation
Managing personal care
Carer responsibilities
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Household tasks and gardening
There is no harm in being a bit less
particular about the housework and a few
weeds growing in your flower beds will be
of little consequence. Except if you are
the kind of person who has taken great
pride in your house or garden you may
find it a bit disheartening to watch, each
day, the build up of jobs that you are no
longer able to tackle. Having help with
cleaning or gardening may seem an
expensive luxury but if you have a small
amount of help, perhaps once a fortnight,
to keep on top of the jobs you can no
longer do, you will feel much more in
control of things and will be able to get
on with the jobs that you can do.
How to find help
Depending on where you live you may
already know of reliable, trustworthy
local people who can help. Alternatively
you may wish to find out if there are any
voluntary agencies that could provide you
with the service you need (Age UK or
Carers Organisations) or you could
contact a registered Domiciliary Care
Agency. There are over 7000 such
agencies around the country. They
provide all kinds of help in your home
from cleaning, shopping, laundry to
helping you with your personal care. A
registered Domiciliary Care Agency may
be a little more expensive but it does
have the advantage of being regulated
and continuously monitored for
compliance with essential standards and
quality. The staff should have DBS checks
(Disclosure & Barring Service). You
should also have back up from the agency
if your worker is ill or unable to attend.
You can view registered Domiciliary Care
Agency inspection reports on the
following websites or the agency should
be able to provide you with a copy:-
Care Quality Commission (CQC) in England www.cqc.org.uk (Tel: 03000 616161)
Care and Social Services Inspectorate in Wales www.wales.gov.uk/csiw (Tel: 0300 7900 126)
Care Inspectorate for Scotland www.careinspectorate.com (Tel: 0345 600 9527)
The Regulation Quality and Improvement Authority (RQIA) in N. Ireland www.rqia.org.uk (Tel: 028 9536 1111)
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We suggest you work out what tasks you
would like help with and how often, and
then discuss this with a few agencies to
get a feel as to whether their service will
suit you. It is likely that if you want to
take it further they will arrange to come
and see you to work out a plan and the
costs. Consider which agency best suits
your needs and requirements.
Do they listen to what you are asking?
Do they seem friendly and caring?
Do they have a list of services you could draw on in the future if you should need them?
Can they come at a time that suits you?
Usually there is an hourly fee and, in
addition, mileage will be charged. Having
an existing arrangement with a care
provider can be a real bonus should you
or your partner become ill or
incapacitated as you will already have a
relationship with your worker and with
the agency and will have support to fall
back on.
Help with gardening may be more difficult
but you could advertise locally for
assistance or enquire about whether your
local Home Improvement Agency has a
gardening service. Depending on where
you live, and your garden space, you may
be able to have an arrangement with an
enthusiastic local gardener who could
grow vegetables in your garden in
exchange for a little help tidying up your
flower beds and cutting your lawn.
Getting out and about
Sometimes things become more difficult
for people when they have to give up
driving or their mobility declines.
Domiciliary Care Agencies can help you
with shopping but there are other things
you might try first that will enable you to
feel more independent.
If you can still drive but your mobility is
severely restricted, then consider
applying to your local council for a Blue
Parking Badge. This is a scheme to enable
people with mobility problems to have
better access to shops and facilities.
Badge holders can use designated parking
spaces and there is a relaxation on the
rules regarding parking restrictions. A
driver or passenger can apply for the
badge.
Consider using the Shopmobility services
available in most large shopping centres.
A range of equipment can be borrowed at
very reasonable rates.
Community Transport schemes operate in
many areas although some rural
communities may not be so well served.
There may be adapted community buses,
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volunteer cars/drivers or dial a ride
schemes to take you to shopping facilities
etc. To find out more about what your
area offers, get in touch with your local
volunteer bureau/ Council Adult help
desk or search the Home Services
Directory on www.housingcare.org
website. Community Transport may not
be immediately available if you need it at
short notice, so some forward planning
and booking in advance is often required.
Shopping
Many of the larger supermarkets now
offer internet shopping. In the comfort of
your home you can browse the’ virtual
shop’ and place your weekly shopping
order from your computer, if you have
one. You decide when you would like
delivery and your goods will arrive at your
home at the designated time. There is
usually a small charge. This is such a
useful service that if you are not already
using a computer it is a very good reason
to start learning. There are lots of
courses for older people to learn
computer skills and the over 50’s now
account for 31% of the UK net audience.
Ask at your local library about what is
available or see if the local Age UK has
any courses or tutors to help you.
Internet shopping, of course, is not
restricted to supermarkets. Most goods
including clothing, furniture, gifts and
electrical goods can now be bought
online, there is the added advantage of
being able to check and compare prices
before buying.
Managing bills and personal affairs
These are things that need to be
organised carefully. It is not unusual for
people to find bills and paperwork
overwhelming particularly when visual
problems, difficulty with concentration
and memory lapses arise.
A good place to start is to reduce the
burden of paperwork you receive by
arranging direct debits or standing orders
for your regular household bills. This can
benefit you further as many utilities offer
discounts on bills that are paid in this
way. Ask a family member or trusted
friend to help you. With their help make
an inventory or list of your important
documents and ensure that these are
stored in a safe place.
You can reduce the amount of paper
work you receive by subscribing to the
Mail Preference Service. This allows you
to stop unsolicited mail and marketing
materials by about 95%. You can register
for this service online at
www.mpsonline.org.uk or write to Mail
Preference Service, DMA House, 70
Margaret Street, London, W1W 8SS Tel:
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020 7291 3310. It is a free service.
Lasting Power of Attorney
Have you considered making an
arrangement for a Lasting Power of
Attorney? The LPA is a legal document
that grants someone you trust the right to
look after specific aspects of your
financial affairs and/or health and welfare
in the event of you losing the mental
capacity to make decisions for yourself.
Your solicitor will help draw up a LPA with
you, while you are able, and it can only be
registered once you are assessed as no
longer having mental capacity.
Often we shy away from talking to family
members about these matters but by
acting now you are exercising your right
to take control of how you want things to
be done and it is always helpful to family
members to have clear guidance as to
your wishes. You will be reassured that
someone that you have designated will
look after your interests.
Keeping active
Whatever your age or state of health,
regular exercise remains very important
for physical and emotional well being.
Inactivity leads to reduced strength and
endurance, reduced balance and
flexibility and in turn places you at
increased risk of falls. Activities such as
swimming, walking, golf, rambling, Tai
chi, Yoga, Pilates can all be enjoyed by
older people and as well as the physical
benefits, exercise is frequently
recommended for people who suffer
from low mood or depression.
If you are unable to take part in the more
strenuous activities get in touch with your
library or local council or Age UK to find
out what is available locally for older
people. In many areas there are classes
you can join for seated exercise and
stretching. Wherever possible keep
active at home, get help with the things
that you cannot do, but maintain your
independence with the things you are
able to do. If you are struggling to get out
of your chair or bed or you are worried
about your mobility, contact your local
council for an assessment by an
Occupational Therapist, or a Home
Improvement Agency. It is likely there
may be some small aids that you can
borrow or buy to enhance your mobility.
Home Improvement Agencies specialise
in carrying out any adaptations that you
could benefit from, such as an extra stair
rail or a rail by the bath.
Take advantage of the services
mentioned earlier, Shopmobility,
Community Transport, Blue Badge
Scheme to help you to remain active and
involved. Don’t forget about travel
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concessions on railways for older people
and bus passes from your local council.
Maintaining contact with friends,
family and social networks
This is very important. People who enjoy
contact with friends and the community
tend to have good support systems if they
are unwell or in difficulty; equally you can
also be of help to others who may be
needing support at a difficult time. If ill
health or disability prevents you from
keeping in touch with friends as you used
to, you may need to work hard to keep
contact going.
When we are at home all day it is easy to
think that we have nothing to offer, we
have no exciting events to talk about and
life may seem too mundane to relate to
others. People of all ages appreciate a
call to see how they are. You may have
family and grand children and however
busy they are, you can be sure that they
will continue to appreciate you taking an
interest in their lives.
When family or friends have difficulties
you may think that you cannot help them
because of your physical condition but a
sympathetic ear is very often all that
people need to get them through.
Organisations like Age UK may be able to
put you in touch with other people
nearby who are housebound like you with
a view to setting up friendly calls. Also
many clubs and societies for older people
have transport that they can arrange for
you. It is never too late to make new
friends.
Using the internet is a great way to keep
in touch with friends and family through
regular emails, and you can connect with
any of your previous interests or hobbies.
You can have your computer set up to
speak to relatives anywhere in the world
with a video link on your screen. This is
quick and easy to set up and as long as
you have an internet connection and a
webcam, it is free!
The Government has committed to
promoting, improving and extending
internet access for older people and with
the new Digital Inclusion Programme has
started providing resources to sheltered
housing schemes to achieve this
objective.
If you live in a sheltered housing scheme
express your interest in taking part. The
organisation Digital Unite has various
programmes for supporting ‘silver surfers’
and a network of tutors throughout the
country to help older people learn about
digital technology. For more information
go to www.digitalunite.com or telephone
0800 228 9272.
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Meal Preparation
This is often a problem for someone who
is living alone. Possibly you haven’t been
used to doing the cooking or you find that
the effort required is too much. There are
short cuts that you can try. Many
supermarkets now have readymade
meals for one person that can be quickly
heated in the microwave or oven. Try not
to rely on them too much because they
may have high sodium levels and high
levels of fat. Several companies that
operate countrywide deliver home
cooked frozen food to your door and they
are very much geared to the older
market. You choose your meals from a
brochure, with special diets catered for,
and then order by telephone or the
internet. Your area is likely to have a
specified delivery day. You will need
freezer space to store the meals.
You may qualify for meals on wheels from
your local council, where hot meals can
be delivered daily but you are unlikely to
have a choice of menu.
Most people combine ready meals or
delivered meals with fresh fast food for
other meals (cereal, fruit, sandwiches,
cold meat, cheese, yoghurts etc).
Sometimes cooking becomes unsafe
either because you are physically frail and
unable to balance long enough with
heavy pans. Maybe visual impairment is
affecting your ability or your memory is
failing and you are unable to safely use
appliances. In these circumstances you
should ask for an assessment by the local
council, there may be simple aids that
could enable you to carry on with some
tasks in the kitchen and you could qualify
for help with meals on wheels or possibly
help with preparing a cooked meal.
Managing personal care
Personal care means help with tasks such
as washing and dressing, bathing,
showering or getting to and from the
toilet. If you are beginning to struggle
with managing any of these things it is a
good idea to get advice. Many people
struggle on and let things get worse
before seeking help, sometimes it is not
until they have had a fall that they take
action. Ask your local council for an
assessment by an Occupational Therapist.
They are professionally trained people
who specialise in helping people facing
everyday challenges and look at ways of
promoting independence in all aspects of
daily life. They may be able to offer
suggestions of alternative ways of doing
things, they may suggest you use a
particular aid or suggest installing a rail by
your shower, bath or toilet etc. Many of
the things they suggest can be provided
free of charge but if you need more
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expensive work done to your property
they can help with putting you in touch
with a Home Improvement Agency (HIA)
or help with applying for grants from your
local council.
The Occupational Therapist might suggest
a period of Intermediate Care to enable
you to get back to your former
independence. This will consist of a
period of rehabilitation in your home
perhaps with several visits a week where
rehab assistants work with you to
overcome your difficulties. It is funded by
the NHS for up to 6 weeks and is often
used to prevent an unnecessary
admission to hospital, perhaps when
someone has had a period of ill health.
There are various providers of personal
care if you need assistance to manage
either in the short or long term; private
domiciliary care agencies, voluntary
organisations and the local council adult
care departments. As mentioned
previously all providers of personal care
should be registered and will be
inspected to ensure that minimum
standards are met. Personal Care can
mean anything from just having
supervision or help with a bath or shower
once a week to having someone come
into your home several times a day or in
some cases people have 24 hour live-in
care.
Funding Personal Care
If you require help with your personal
care you may qualify for assistance from
the local authority. Ask your local council
Adult Care Department for a Care Needs
Assessment. As well as your needs being
assessed, you will require a financial
assessment and if your savings are below
£23,250 the local authority may be able
to help with the cost of your personal
care. Some local authorities will arrange
the care for you and will discuss any
charges with you but increasingly councils
are encouraged to use a method of direct
payments (sometimes called individual
budgets or personal budgets) whereby
you are allocated a sum of money to
purchase and choose services yourself.
If your savings exceed £23,250 the local
council should still provide you with
information and advice to enable you to
organise the help that you need.
Irrespective of your savings, if you need
assistance with your personal care you
are likely to qualify for Attendance
Allowance. This is a non means-tested,
non-taxable allowance. There are two
levels of benefit, the lower rate
(£58.70pw) for people who need care
during the day or night and the higher
rate (£87.65pw) for people who need
care during the day and night. Telephone
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the Attendance Allowance helpline on
0800 731 0122 for an application.
For people who have very high care needs
and perhaps require carer assistance
several times a day, through the night, or
24 hours per day, the cost of care can be
very expensive. You may have considered
other options such as ‘housing with care’
or a residential care home but you remain
committed to staying put. Assuming that
you own your property, one way to
ensure that you have adequate funds to
continue paying for your care would be to
consider releasing equity in your home.
This requires very careful consideration
and you should seek professional advice
from a reputable person with experience
of this process. In the first instance you
should check with your local authority as
to what financial assistance might be
available. You might also read our Equity
Release factsheet that covers this subject.
Telecare
As mentioned previously there are
numerous aids and adaptations available
to help you to manage at home but
assistive technology is another area that
is of growing relevance to older people.
This equipment is usually referred to as
Telecare. Telecare enables you to call for
assistance day or night. Many people are
familiar with the now widely used
“careline” or “pendant alarm” systems
that allow people to call for help in the
event of a fall or other emergency, but
there is now an increasing range of
equipment, such as:
Equipment to remind people to take their medication
Flood detector for sink or bath
Carbon monoxide and natural gas detectors
Temperature extremes sensor
Falls sensors can be placed by bed or chair or where there is a risk of falls
Sensors to monitor normal daily activity and variations from the norm will prompt an alert
Sensors to alert a carer to a wet bed
Property exit monitor to detect if door has been left open or if someone leaves the house at an unusual time
There are many providers of community
alarms or carelines. Some are run by
local housing departments or charities
such as Age UK, others are provided by
commercial firms. The charges and
services may vary, so shop around to find
the one that best suits you.
To find out more about Telecare
equipment contact your local Adult Care
Department. In the near future it is
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expected that greater use will be made of
‘Telehealth’ equipment. So you may find
that your doctor will provide equipment
to conduct simple tests and monitor your
health at home reducing the need for you
to attend clinics or hospital. Telecare can
provide an inexpensive solution to many
problems and can provide peace of mind
to the older person and their family. In
many instances the Telecare facility may
allow your family to have a closer insight
into your wellbeing and enable them to
improve contact with you.
Carer responsibilities
As our needs increase we can often come
to rely increasingly on others for help. It
is important that we take care of our
carers too and that they do not lose sight
of the importance of having some time
for themselves as well as other forms of
support in their vital role. A carer is
someone who gives regular unpaid help
to someone, for example their partner,
family member, friend or neighbour. In
most areas there are organisations that
are there to support carers. Carers UK for
example, has a wide range of services
that can be accessed including practical
and emotional support. Go to the
website www.carersuk.org to find your
nearest carer organisation or telephone
0808 808 7777. You can also ask your
local council Adult Care Department to
arrange a carer’s assessment; this may
give access to supports such as the carers
emergency scheme, direct payments and
carers grants.
Conclusion
While this leaflet does not pretend to
provide solutions to every problem it
does provide a starting point with ideas
and suggestions for helping you to remain
self-reliant and actively engaged in
finding the right solutions to the common
difficulties that arise in later life. Many of
these are manageable.
Frequently the challenges of older age
can be overcome or attenuated by a
combination of early planning, practical
help, awareness of services available and
the support of friends and family.
In many instances you may be able to
remain independent throughout older
age. But the overall message is that it is
important to plan well and act early.
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About FirstStop Advice
FirstStop is a free information and advice
service designed to help older people
decide how best to meet their needs for
support, care and suitable housing. It is
provided jointly by a growing number of
national and local organisations and it is led
by the charity, Elderly Accommodation
Counsel (EAC).
Contact us
Visit us online: www.housingcare.org
Use our housing options self-help tool at
hoop.eac.org.uk
The information contained in this factsheet
is intended to be, and should be regarded
as, a brief summary and is based on our
understanding of present legislation,
regulations and guidance. No responsibility
can be accepted for action based on this
information.
April 2019